Alcoholism Assessment and Treatment

OBJECTIVE: The purpose of this protocol is to create a mechanism whereby the intramural
program of the NIAAA can evaluate and treat a broad range of people with drinking problems at
the NIH Clinical Center (CC) in Bethesda, MD. Through this program, participants will receive
comprehensive, state-of-the-art treatment for their alcohol, psychosocial and medical
problems. The protocol will allow us to evaluate and recruit participants who will then be
eligible for more focused clinical research efforts to advance the NIAAA research goals.
Additionally, this protocol will allow investigators and staff to gain broad training
experience in alcohol and addiction medicine through the clinical care of such patients.

STUDY POPULATION: The protocol is open to any adult who is seeking help for a drinking
problem and who is likely to qualify to participate in another NIAAA protocol. Participants
will be recruited through local media and professional avenues in the Washington, DC Metro
area.

DESIGN: Participants will be evaluated by a nurse and physician, among others, who will
determine the need for hospitalization, detoxification and to address other issues. For those
needing medically supervised detoxification, a standard program of monitoring and treatment
with benzodiazepines and other medications will be instituted. A standard battery of
screening blood, urine and other clinically indicated tests, an electrocardiogram, chest
x-ray and MRI of the brain will be done as part of the comprehensive medical and

neurological assessment. Following admission, participants will undergo a series of verbal
and observational-type assessments designed to evaluate psychiatric co-morbidity,
psychopathology, psychosocial problems, neurocognitive function, personality and other
factors relevant to alcoholism treatment. Following discharge from the inpatient program,
participants will be offered up to 16 weeks standard-of-care behavioral outpatient treatment.
At five points during the outpatient phase, participants will come to the clinic for selected
blood and urine tests, interviews and verbal/observational assessments to evaluate abstinence
from alcohol and identify changes in various psychological dimensions. During their
participation in this protocol, participants will be approached to consider enrolling in
other clinical research protocols such as imaging studies and drug-treatment trials. For
participants willing to participate in these other protocols, other appropriate consent(s)
will be obtained.

OUTCOME MEASURES: Because of the evidence-based nature of all assessments used in this
protocol, data obtained through them can serve at least three clinical purposes: first, to
provide a basis for individualizing patient treatment, enhancing motivation to change, and
following-up such treatment for the sole purpose of providing optimal clinical care; second,
to provide patient characteristics and outcome data for specific research protocols to which
the patient may additionally and separately consent; and third, to provide data for
monitoring the performance and functioning of the program as a whole.

- INCLUSION CRITERIA:

Age greater than 18 years old.

Are seeking help for alcohol drinking-related problems.

EXCLUSION CRITERIA:

People with medical problems that cannot be adequately managed at the NIH Clinical Center,
as determined by the medically advisory investigator, in consultation with relevant
Clinical Center consult services as needed.

Serious neuro-psychiatric conditions which impair judgment or cognitive function to an
extent that precludes them from providing informed consent, such as acute psychosis or
severe dementia (incompetent individuals).

People who are unlikely or unable to complete the treatment program because they become or
are likely to be incarcerated while on the protocol.

People who are required to receive treatment by a court of law or who are involuntarily
committed to treatment.